Many older Americans undergo routine cancer screening tests even though guidelines recommend against them, according to a study published online this week by the Archives of Internal Medicine.

Researchers from the University of Connecticut looked at cancer screening data for some 50,000 people in the federal National Health Interview Survey. Among women ages 75 to 79, nearly two-thirds had received a mammogram in the past two years, as had nearly half of those 80 and older. Similarly, 53 percent of women ages 75 to 79 and about 40 percent of women 80 and older reported having a pap smear.

Older men were actually more likely than younger ones to undergo prostate cancer screening. Specifically, 40 percent of men ages 70 to 74 had received a PSA blood test in the past year, compared with 57 percent of men ages 75 to 79 and 42 percent of those 80 and older.

Reported screenings for colorectal cancer in men and women were highest in the 75- to 79-year-old group, with 57 percent of participants reporting screening.

The U.S. Preventive Services Task Force recommends against routine screening for breast, colorectal, and prostate cancer for people 75 and older, and advises against pap smears for women 65 and older.

But the authors emphasize that those are just general guidelines, and are not “one-size fit all” mandates. Instead, they say that screening recommendations should be individualized based on overall health and the patients’ values and preferences.

And in an accompanying editorial, Louise C. Walter, M.D., of the University of California, San Francisco and San Francisco Veterans Affairs Administration Medical Center, concludes:

While arguments persists about what is the 'right' rate of cancer screening in older persons, it seems clear that the rate of informed decision-making should approach 100 percent.

Read more about our advice on the screening tests you need, and those you might not.

Source
Prevalence of Cancer Screening in Older, Racially Diverse Adults. Still Screening After All These Years. [Archives of Internal Medicine]